Provider Demographics
NPI:1659766673
Name:LAUREN E. SCHULTZ, DDS, PC
Entity type:Organization
Organization Name:LAUREN E. SCHULTZ, DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHULTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:847-698-1199
Mailing Address - Street 1:933 N NORTHWEST HWY
Mailing Address - Street 2:300
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-5900
Mailing Address - Country:US
Mailing Address - Phone:847-698-1199
Mailing Address - Fax:847-655-6785
Practice Address - Street 1:933 N NORTHWEST HWY
Practice Address - Street 2:300
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-5900
Practice Address - Country:US
Practice Address - Phone:847-698-1199
Practice Address - Fax:847-655-6785
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-06
Last Update Date:2015-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0287091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty